TKR Should I have LTKR before hiking 7 day Inca trail

[whoshebaby]

I’m 73, fit for my age 5’7” 128 lbs. with no underlying problems other than bone on bone in left knee and soon to be the same in the right knee… in other words I’ve trashed my knees due to countless 10k, 15k, and 1marathon over my young / mid life / older adult years. I’ve committed to walk the Salkantay trail to Machu Picchu (7 days) in 11/23. My question to you is (1) can I do this trek w/o having LTKR or Will I have enough time to rehab if I have it done before the trip. Secondly, if I have this surgery done what could possibly prohibit me from even doing trip? I lead a fairly active life despite these knee issues as I stay fit, stay active and keep moving. Please advise. Thanks.

 

[Layla]

Personally, I'd target TKR sooner, rather than later.
I don't know how soon you're able to get a surgery date because some wait months for their dates. If your knee is bone on bone now, there is no guarantee you'll even make the trip, without knowing how quickly your knee may deteriorate between now and then.

As far as healing goes and whether you'll be physically ready for the trek depends a lot upon when you will have the surgery if you decide on doing it before the trip. Again, personal opinion, I think you have a better chance of making the trip if you have surgery soon and begin recovering, over hoping that your knee will be in shape to make that trek ten months from now.

I'll leave some pre-op reading for you with best wishes as you make decisions and move forward. Stay in touch, we'd love to support you through all.

KNEE PRE-OP ARTICLES

If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:

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Score Chart: How bad is my arthritic knee?​

Choosing a surgeon and a prosthesis​

BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery​

Longevity of implants and revisions: How long will my new joint last?​

If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:

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Recovery Aids: A comprehensive list for hospital and home​

Recliner Chairs: Things you need to know if buying one for your recovery​

Pre-Op Interviews: What's involved?​

Regardless of where you are in the process, the website and app My Knee Guide can help you stay organized and informed. The free service keeps all the information pertaining to your surgery and recovery in one place on your smartphone. It is intended to be a personal support tool for the entire process.

And if you want to picture what your life might be like with a replaced knee, take a look at some stories of amazing knee recoveries

 

[Claire56]

@whoshebaby Just my opinion but I would postpone the trip until after the surgery. If your knees felt like mine, you will enjoy the trip more once you are walking comfortably again. As the moderators will say, recovery can take a year or more. BUT if you don't have any complications, you may be able to do the trek before a year.

 

[whoshebaby]

Thank you Claire56 and Layla for your input.

I'm seeing the orthopedic tomorrow to let him know that I've committed to the Salkantay trek to Machu Picchu in November 2023. Need his input regardless of whether or not he thinks it's ok or not. My knees aren't ailing me much as I am an avid walker/cyclist and keep my legs strong. I'm concerned if there are complications if surgery is done before the trip. We'll see what he says. I'm bringing the information re: trip and it's elevation/descents. Not a cake walk; but it seems manageable. I completed the Camino de Santiago in 2017 (800 km)and in 2019 with bad knees. Of course, the poles helped me a lot. Doctor's input will be valuable.

 

[Jaycey]

It's best to get your surgeon's input on this. He has seen all the diagnostics and knows your medical situation. Layla is right - getting TKR done sooner rather than later is really the best idea. These joints tend to go from tolerable to horrid overnight - especially if the joint is already bone on bone.

 

[JusticeRider]

Hi @whoshebaby , fellow hiker here. You’re probably not going to want to hear this, but I think you should cancel that trip. I hiked, snowshoed, and backpacked on bad knees for years and years. I always managed and knew how to accommodate them. In 2020 I had what I thought was a minor injury to my knee that felt better after just a couple days. A couple weeks after that, I went on a 5 day backpacking trip in the North Cascades in WA state.

The first day went great, tackled some big elevation gains and all was well. Midway through the second day we stopped for lunch at the top of a big pass and when I stood up and took a step I had 9 out of 10 stabbing pain in my knee. Putting weight on that leg was excruciating. I don’t know what shifted, but my knee had suddenly decided, that was it. I was still 25 miles from the nearest trailhead with two more days and two more mountain passes to go. It was either call for search and rescue or somehow hike out. I chose to hike out. I had trekking poles and my hubby took some of my pack load and for two hellish days, I limped out of the mountains. I would not recommend an experience like that to anybody. And as Jacey said, you never know when your knee is going to go from tolerable to horrid.

As for doing the surgery before the trip, even if you had your surgery tomorrow, you are looking at less than a year post op. And if you have to wait 2 or 3 months (which is common) you could be looking at a mere 7 months post op. I am young and strong and highly motivated and thought I’d heal quickly. But things don’t always go the way you think they will. I’m at 5 months right now and improving slowly but surely, but I cannot imagine trying to do a 7 day trip two months from now. Bodies don’t always heal on our timelines.

Anyway. Sorry for the novel, but I hate to see you put yourself at risk or set yourself up for a pressured and stressful recovery and possibly ruined plans. Just my 2 cents. Wishing you well!

 

[whoshebaby]

@JusticeRider
Thanks for your insight . The trip is in November of this year, not in two months. I will not be carrying a backpack. The guides/sherpas carry the bags. Thanks for being so candid and upfront. Here's my question. Look up Mountain to Lodges - the 7 day Salkantay Trek to Machu Picchu if you're able to. I'll show the info to the doctor; however, what you're saying is, it doesn't matter because the risk involved taking such a trip in the middle of nowhere could end up a nightmare. Now there is some relief on the trek if a hiker is having issues; there are horses that can assist in the ascents/descents if necessary.

 

[Hip4life]

I had to post-pone a much anticipated return to Yellowstone National Park. Not Machu Picchu, mind you, but it has its challenges. In my case, it was my hip. With bone on bone then, other joints started screaming too trying to compensate. If we had pushed on, the trip would have been miserable and I would have been more disappointed to have had to abandon it mid-trip. All that expense and work and time, not to mention money and not get to enjoy it? No, thank you. As it turned out, it was delayed a couple more times with Covid and the flood up there. But we finally made it and it was glorious! I hiked anywhere we chose without a second thought and enjoyed myself more than I could have imagined. It was so worth the wait. Give it serious thought. Machu Picchu isn't going anywhere. It will be interesting to hear your ortho's take on it.

 

[whoshebaby]

Thanks, Hip4Life. I'll keep you posted.

 

[JusticeRider]

Hi whoshebaby, I’m glad you appreciate my candor! Just here to help

what you're saying is, it doesn't matter because the risk involved taking such a trip in the middle of nowhere could end up a nightmare.

Yes, exactly. I read about your trip…omg sounds incredible!! All the more reason why you could enjoy it so, so much more if you didn’t have to worry about your knee. Do it when you’re strong and 100%!

It definitely helps that you don’t have to carry weight and you will be stopping at lodges each night. But you still have to get down somehow if the knee goes awry.

So worst case scenario you end up terrible pain partway through and have to be put on a horse with a painful knee and carried down the mountain. Then you are in Peru barely able to walk and have to figure out how to get home to the states and see your doctor asap. Sorry…more of that wonderful candor, ha!

As far as after the surgery, we all have so much pressure put on us anyway by our doctors, PTs, friends, etc to heal faster, to do better sooner! It’s very stressful and demoralizing at times. And it doesn’t help with healing. I just think by trying to force your knee into a certain timeline, you’re only adding to the pressure you’ll probably already be feeling. It will be that much more frustrating if you don’t heal as fast as you need to by that deadline.

The trip is in November of this year, not in two months

I got that. I just meant that in two months, I’ll be 7 months post op. And no way I’d be ready for a 7 day trip! I wouldn’t even want to try it 3 or 4 months from now. But then, maybe I just have PTSD from that awful experience in the North Cascades?

 

[whoshebaby]

I did the northern Cascades this past year June 2022 - stayed at the Stehekin Lodge and hiked various trails (7 mi a day) in the area. Joyful and beautiful. Knees did well; I just took it easy while my friends went ahead of me...so what..didn't matter. Is wasn't a race. LOL

 

[JusticeRider]

I LOVE Stehekin! So beautiful up there and the lodge is so cute. Did you go to the famous bakery?

 

[whoshebaby]

Oh yes!

 

[Claire56]

Just a thought, if this is a trip with friends, you will get a lot of sympathy/empathy if you find yourself in need of help. If it is with a group of strangers, not so much.

 

[whoshebaby]

Saw the orthopedic doctor yesterday. Once again, he was very professional, kind, and supportive. Based on what he knows about my history, daily low level of pain, level of fitness; and knowledge of previous hikes and pain tolerance, he said for me to go on the trip and that not everyone needs TKR if they're bone on bone. I'll go with that for right now though keep my options open.

 

[LD of Michigan]

@whoshebaby Just my opinion but I would postpone the trip until after the surgery. If your knees felt like mine, you will enjoy the trip more once you are walking comfortably again. As the moderators will say, recovery can take a year or more. BUT if you don't have any complications, you may be able to do the trek before a year.

I agree. For me my first TKR was a healing process on multiple levels - taking about a year. Sure I went back to work within five and half weeks, with modifications made on stand and for certain I got on my four-wheeler and into the bed as soon as I got home. COVID also impacted my recovery as I was stuck in the house somewhat, but then started walking my neighborhood so as to not loose the flexibility and strength gained from my PT.

The working (as we returned to work) gave movement and activity on my cane. Yet strenuous, continuous walking would not have been possible. But sitting about was not using and keeping my knee flexible - so three-quarter level work was like a version of PT, manageable as requested. I did not travel or doing anything strenuous walking, or walking events sans a cane for about a year.

I'll never do extensive travel/ fly without a fold-down cane. Better to have than not. Especially at airports etc where people will otherwise throng behind me too fast.

I look forward to light cycling again with now two brand new knees!